Responding to a Public Health Emergency: The Opioid Crisis in BC - Part 1
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Transcript of Responding to a Public Health Emergency: The Opioid Crisis in BC - Part 1
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British Columbia’s Response to the Opioid
Overdose Emergency
Presentation to BC Patient Safety and Quality Council
March 3, 2017
Dr Bonnie Henry, Deputy Provincial Health Officer, OPHO
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Paul Adkin (right) died
on Sept. 28 leaving
behind grieving friends
and family members,
including dad Tom and
brother Matt (left).
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Increase in Opioid Overdoses
Rising fatalities from illicit drug overdoses in BC
noted in 2015 and early 2016
Fentanyl detection rising rapidly, detected in 60%
of overdose deaths to date in 2016 vs. 30% of
overdose deaths in all of 2015.
922 illicit drug overdose deaths for all 2016
505 overdose deaths in all of 2015
268 overdose deaths in all of 2014
116 illicit drug overdose deaths in January 2017
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Increase in Opioid Overdoses
Significant regional variations
Multiple groups at risk:
Illicit opioid users
Street involved
Employed/housed and otherwise invisible to the health system
Individuals discharged from corrections
Individuals discharged from abstinence-based opioid
addiction treatment
Experimenters
Occasional users, stimulant users
Chronic pain patients
10 Photo credit: CBC News
B.C.’s Response
Provincial Health Officer declared a public health
emergency in April 2016
Premier Clark established a Joint Task Force on
Overdose Prevention and Response in July 2016
co-chairs: Perry Kendall and Clayton Pecknold
Leadership Council established a Health System
Steering Committee on Overdose Prevention and
Response
co-chairs: Lynn Stevenson and Perry Kendall
Six task groups struck to immediately scale up action
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Significant Investment in Response
The province has earmarked over $70 million dollars
to support the response to the crisis, including:
Establishment of the BC Centre on Substance Use
Joint Task Force initiatives
BC Emergency Health Services
Addictions treatment services
Plan G incorporation of methadone and Suboxone
Public awareness campaign
$10 million investment from federal government
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BC’s Plan: Seven Key Areas of Focus
1. Immediate response to an overdose
2. Preventing overdoses before they happen
3. Public education and awareness about overdose
prevention and response
4. Monitoring, surveillance, and applied research
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Key Areas of Focus - Continued
5. Improvements to federal legislation, notably the
federal Controlled Drugs and Substances Act
and Precursor Control Regulations
6. Improving federal enforcement and interdiction
strategies
7. Enhancing the capacity of police to support harm
reduction efforts related to street drugs
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1. Immediate Response to Overdoses
Supervised consumption service applications
Naloxone expansion
MMU deployment
Psychosocial supports for front line workers
Guidelines for BC Housing developed
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1. Immediate Response to Overdoses
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Federal regulatory actions
Bill C-37
Prescription Drug List
Provincial regulatory actions
Ministerial orders
Naloxone regulation changes
2. Preventing Overdoses Before They
Happen
Regulatory changes
in OAT patients
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3. Public and Professional Awareness
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4. Surveillance, Prescription
Monitoring and Applied Research
Weekly enhanced reporting by the BC Centre for Disease
Control (BCCDC) on overdose data
BCCDC publicly facing reports
Three applied research projects underway (OPTIMA, TASA,
Emergency Department Opioid Overdose Treatment Study )
BCCDC providing regular enhanced surveillance reports in
response to decision-maker queries
Coroners Service Drug Death Investigation team launched to
enhance investigations into illicit drug overdoses
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4. Surveillance, Prescription
Monitoring and Applied Research
Investment in technological improvements at BCCDC to
improve real-time information sharing across the province
Increase capacity of provincial toxicology labs to test blood
samples for opioids and other new substances by procuring
testing equipment (e.g., mass spectrometer)
Health Canada has approved testing for carfentanil within BC
rather than having suspect substances sent to the federal
laboratory for testing; BC will be able to test for carfentanil
starting in March 2017
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5. Improvements to federal legislation
Bill C-37 and the new Canadian Drugs and Substances
Strategy
Health Canada has restricted six chemicals used in the
production of fentanyl to render the unauthorized importation
and exportation of these chemicals illegal
The RCMP and Chinese Ministry of Public Security
announced joint efforts to curb importation of fentanyl into
Canada
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6. Improving federal enforcement and
interdiction strategies
The Joint Task Force continues to work with police and law
enforcement to support expansion of interdiction efforts
including the co-ordination of efforts to intercept, detect, and
investigate illegally imported fentanyl and precursors
The Canada Border Services Agency has reported success
intercepting fentanyl entering Canada, and the RCMP and
some municipal police departments have reported multiple
seizures of fentanyl and detection of other substances
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7. Enhancing the capacity of police to
support harm reduction efforts
Enhanced and ongoing communication among law
enforcement agencies to ensure that appropriate information is
available to police services to formulate local operational
policy and ensure that they have the supports to work with
community partners to decrease opioid overdose deaths
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Questions and comments?
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